When Leslie Hernandez left her waterfront house on April 29, she expected to be returning soon. She knew the Mississippi river was rising and had even taken the precaution of removing her possessions from her home with a friend's trailer. But Hernandez, a native of Tunica, Miss., had dealt with floods before -- and besides, her house was built on stilts.
"I took it for granted that we'd automatically go back afterwards," she said. It was "a slap in the face" when, on her 52nd birthday, she was shown the first pictures documenting the damage done to her home and others' in the Tunica waterfront community known as the Cutoff.
Though the slow rising of the Mississippi river following April's storms has given many regions time to prepare for the oncoming floods, the shock of evacuation is a hefty burden for the thousands of citizens displaced from their homes in Tennessee and Mississippi.
"Those who have to evacuate will deal with a major sense of loss, but will also have to deal with the stress of uncertainty," said Priscilla Dass-Brailsford, associate professor of psychiatry at Georgetown University.
Hernandez's neighborhood, built beside a lake that was "cut off" from the Mississippi river in the 1940s, was evacuated on April 29 in anticipation of the flood. No one will be allowed back in for several weeks while FEMA assesses the danger. For the time being, photos taken by aid workers from a few days ago, before the flood even crested, are all that Hernandez has to go on.
"The water comes three quarters of the way up my house. This time the flood's destroyed everything I had. And we're not going to know anything for weeks -- whether my home is condemned, if I'll be able to afford to rebuild," she said.
"It's just that anxiety of the day-to-day basis -- not knowing what will happen, nothing is secure. It's just awful, but I'm blessed to have friends to stay with and…I have all my belongings out," she said.
For another Cutoff resident, Harry Johnson, there was only so much a U-Haul could carry out of his lakefront cabin. Picking out what he could and could not live without among his things was not so hard, the 65-year-old retiree said, but trying to select which of his ten-year-old daughter's possessions she would miss the most, "that was really hard."
Johnson is living in a shelter set up by the Red Cross in a Tunica Recreation Center now, along with about 50 other residents from the Cutoff. "They're saying that it's going to be almost July before the water goes back down and we can even go in there, so we all have a stint in here ahead of us," he said.
The Psychology of Natural Disaster
As this spring's flooding continues to roll south down the Mississippi, it leaves more than damaged property in its wake. For the many who will have no home to return to when the waters finally recede, the trauma of what's being called "the hundred-year flood" is only beginning.
For that reason, among the 1,300 volunteers deployed to these flood-affected states, the Red Cross has peppered hundreds of mental health professionals. They will play an increasingly important role with the recovery effort as displaced Southerners start to look towards rebuilding.
"The grieving process itself will be somewhat delayed as they focus on the next steps in ensuring safe shelter, food, etc.," said Dass-Brailsford.
For those who will be displaced for an undetermined amount of time, the anxiety of not knowing whether they will even be able to return to their homes "creates a great deal of stress," said Anthony Mannarino, professor and vice president of the department of psychiatry at Drexel University College of Medicine in Philadelphia.
All of the Red Cross volunteers have been taught psychological first aid, which trains them to identify who will need professional help or might be in the early stages of post traumatic stress disorder (PTSD), said Rob Yin, manager of disaster mental health services for the American Red Cross.
"We know that certain people are at greater risk for depression and PTSD: if they were trapped, if they saw someone get injured or killed, if they were separated from their family, or people who are off medication because they left their pills behind," he said. These people need, if possible, to be offered professional mental health counseling within the first 30 days of the crisis -- the "golden" month for successful outcomes, Lim says.
Building a Levee of Resiliency
Among those who are not at high risk of PTSD but are nonetheless upset, social support systems, such as those found among the Cutoff folk at the Tunica shelter, are essential, psychiatrists say.
"People need to be with each other, [with those] undergoing similar issues as them," said Dass-Brailsford. It "helps their coping" and gives them "validation that they are not the only ones."
Many of the Cutoff residents at the shelter are there because they feel they need the sense of community they had in their neighborhood, said Harry Johnson. He stayed with a friend right after the evacuation, but came to the shelter so that he could be with his neighbors and friends.
"We could go stay somewhere else, but we have our own cultures so to speak, so a few of us have come back here, staying together, supporting each other. Without each other we would have been too tore up by what's happened," he said.
A main concern for mental health relief workers now is building the kind of social support and psychological resiliency that Johnson and his neighbors seem to have in spades.
"Resiliency isn't a static thing; you can increase it," said Lim. "Help people identify small steps, connect with existing support systems, rebuild a routine, even if it's nothing like it was at home -- these are things our volunteers are trained for," he said.
For the people of the Cutoff, that slice of summer routine will come in the form of a old-fashioned community catfish fry Thursday night at the shelter. "For old time's sake," Johnson said, until things get figured out for their submerged, possibly contaminated hamlet.
"It could be a real difficult cleanup process, depending on how much debris, contaminants," said Johnson. "I'm absolutely going to rebuild though. I was in heaven there. You're mind just feels free there on the lake."